Monday, September 25, 2006

A hole in the national consciousness

Just when you may have despaired of reading about Traumatic Brain Injury in the mainstream press, along comes USA Today with a brief but compelling piece headlined "Army explores issue of living wills as more return from war in comas":

A growing number of troops are returning from Iraq and Afghanistan with severe brain damage, prompting the Army to examine whether living wills or other care directives from soldiers ought to be available to battlefield doctors.

...

From January 2003 through July, the Pentagon identified at least 250 troops who returned from war with head wounds that left them — at least initially — comatose or unable to care for themselves or respond to people. Brain injuries, most from roadside bombs, are the signature wound of the Iraq war.

The number is a small part of the 20,000 troops wounded in Iraq and Afghanistan, but it is "unprecedented," says Dale Smith, professor of medical history at the Uniformed Services University of the Health Sciences in Bethesda, Md. "All of these (comatose) people died in former wars before they got home."

The article (as the headline implies) focuses mainly on the issue of living wills. But there's another piece, "Families bear catastrophic war wounds," to which the one above links, which treats the general issue of war-wrought TBI much more personally (emphasis added):

Army chaplain Kenneth Kaibel touched a cup of Communion wine to the lips of Spc. Ethan Biggers, who lay comatose at Walter Reed Army Medical Center. A drop slipped down his throat. The soldier gagged and coughed twice as his stepmother, Cheryl Biggers, cradled him ever more closely.

"That's all right," she whispered, her left hand gently supporting the base of his head. Depressions revealed where battlefield surgeons peeled back his scalp and removed large sections of skull to relieve swelling from a bullet fired by a sniper in Iraq in March.

...

Biggers is part of a small but growing number of catastrophically wounded casualties from Iraq and Afghanistan — many of whom would never have survived this long in previous wars.

According to the Pentagon, at least 250 soldiers and Marines have returned from Iraq and Afghanistan with head wounds that left them — at least initially — comatose or unable to care for themselves.

"We all look at the amputees and say, 'God, they're really lucky,' " says Liza Biggers, 25, who left her career as a freelance artist to devote all her time to her brother.

Think this is just a side-issue of the whole "Should we be in Iraq?" dilemma -- something that will go away once we withdraw, whether it's next month, next year, or 10 years from now? Think again. The questions raised by these casualties -- and how we treat them, individually and as a society -- will be haunting us for decades to come.

Saturday, September 16, 2006

Have We Discovered a New Silent Scream?

The wheels lock, the car skids, you see the 18-wheeler heading for your windshield. You have just enough time to open your mouth. Then the bite of glass and metal, and merciful blackness.

Somebody's talking. You try to open your eyes, but nothing happens. You can't move or feel anything.

...You try to call out, to scream. No one knows you're here, awake inside your skull. No one will ever know.

Saletan's frightening opener was inspired by a report in last week's edition of Science. Seems a group of British scientists used a Functional Magnetic Resonance Imaging scanner to track blood flow to different parts of a "vegetative" young woman's brain. Surprise! "The scan lit up with telltale patterns of language, movement, and navigation indistinguishable from the brains of healthy people."

What does this mean? Well, one thing it doesn't mean is that Terri Schiavo was mentally alert when doctors ceased extreme measures to keep her alive.

The English patient had several factors in her favor: Her injury was traumatic, her brain was largely intact, and she had been vegetative for only a few months. At the other end of the spectrum are people such as Terri Schiavo. Their injuries are caused by oxygen starvation, their brains are liquefied, and they've been vegetative for years.

However, Saletan offers some troubling statistics and questions:

By various estimates, 25,000 to 35,000 Americans have been diagnosed as vegetative. How many of them have received FMRI scans? How many would light up? How many are awake in there?

Monday, September 04, 2006

Blueberries on the Brain

These articles are not new, but they serve as excellent reminders that blueberries should not be overlooked when planning our diets. Researchers believe that blueberries trigger neurons that help keep the brain sharp. According to nutrition researcher James Joseph:

Blueberries have compounds that boost neuron signals and help turn back on systems in the brain that can lead to using other proteins to help with memory or other cognitive skills.

Spinach and strawberries also seem to help with short-term memory loss.